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Original research
Sociotechnical evaluation of a health management information system in South India
  1. Nachiket Gudi1,
  2. Myron Anthony Godinho2,
  3. Dola Saha3,
  4. Padmanesan Narasimhan2
  1. 1 Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
  2. 2 WHO Collaborating Centre for eHealth, School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
  3. 3 Department of Health Information Management, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
  1. Correspondence to Dola Saha, Department of Health Information Management, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India; dola.saha{at}


Objective In India, a Health Management Information System (HMIS) is used to capture and aggregate data from health facilities across the country to inform decision making by healthcare managers and policymakers. In a country with the unparalleled sociocultural diversity of India, the dynamics of sociotechnical systems produce unique challenges. The study attempts to understand the sociotechnical factors that influence HMIS at the district level.

Methods The study is conducted among the healthcare workers who were involved in managing the district HMIS for over a year. We employed quota sampling and conducted face-to-face interviews with eight healthcare workers. The interviews were transcribed and coded using an analytical framework derived from the Performance of Routine Information System Management (PRISM) framework for HMIS evaluation.

Results We identified 61 codes sorted into 11 categories and grouped into 3 deductive themes (derived from the PRISM framework, ie, technical processes, challenges and data quality) and 2 inductive themes (ie, the role of private enterprise and human resource management).

Conclusion The study reveals areas to improve and lays emphasis on change management. Future evaluations should involve a complete evaluation of the district HMIS using the four PRISM tools and will inform a collaboratively developed plan to address HMIS issues for health system strengthening.

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  • Contributors All authors contributed to manuscript writing. NG, MAG and DS contributed to the conceptualisation, design and conduct of the study. PN contributed to analysis and critically revised the manuscript. NG was the principal investigator and led the data collection.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study protocol was approved by the Kasturba Hospital Institutional Ethics Committee (IEC 200/2017). Administrative permissions for collecting data were obtained from the District Health Office of the study site. Written informed consent was obtained from each participant before the start of the interview. Privacy and confidentiality of the participants were maintained throughout the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.